- Email: [email protected]
18. Gender Differences in Research Grant Applications for Pediatric Residents
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ABSTRACTS
ACADEMIC PEDIATRICS
view of teaching as an intellectual pursuit and awareness of ways to integrate teaching and research. FLC is an innovative and effective model of faculty development that promotes a sense of community among faculty.
dentialing. Programs to address gender disparities in grant funding should begin in undergraduate and graduate medical education, focusing on these individual skills and behaviors.
17. WE NEED TO TALK: DISCREPANCIES BETWEEN RESIDENT PERCEPTIONS OF THEIR COMMUNICATION SKILLS AND THOSE OF FACULTY Thanakorn Jirasevijinda, MD, Weill Cornell Medical College, New York, NY, Richard Neugebauer, PhD, Bronx-Lebanon Hospital Center, Bronx, NY
19. EFFECT OF DUTY HOURS STANDARDS ON PEDIATRIC RESIDENT EDUCATION Camden L. Hebson, MD, Kourtney K. Santucci, MD, Andrea L. Klopman, MD, Parminder Suchdev, MD, Lynn Gardner, MD, Susie Buchter, MD, Emory Pediatrics, Atlanta, GA
Introduction: Adults learn a subject best when they see its relevance and perceive a need for improvement. For communication skills (CS), little is known about resident self-perceptions on areas of weakness. Even less is known about how much these perceptions correlate with those of faculty. Objective: 1) Assess resident self-perceptions on deficits in CS, and compare them to those of faculty 2) Compare discrepancies among the three PGY levels. Methods: The Interactive Workshops On Communication and Cultural Sensitivity (IWOCCS) Program at the Bronx-Lebanon Hospital Center provides CS training to Pediatric Residents using interactive and peereducation models. As part of the program’s needs assessment, a survey was administered to 53 faculty and 53 residents, asking, ‘‘Which of the following areas pose a challenge for you/your residents in your/their interactions with patients?’’ The survey items were divided into 3 categories: 1) Rapport Building & Patient-Centered Care 2) Working with Specific Populations 3) Specific Topics in Communication; and their responses structured on the Likert Scale. Data analysis dichotomized responses into agree or other. Comparisons between faculty and resident responses on each item were analyzed using the chi-square test. Results: All three categories showed discrepancies between faculty and resident self-perceptions. The top five items were 1) Incorporating patients into decision making (p ¼ 0.02) 2) Talking about sexuality (p < 0.01) 3) Assessing family dynamics & need for social support (p < 0.01) 4) Understanding patient perspective (p ¼ 0.002) 5) Attention to non-verbal cues (p ¼ 0.03). For concordant items, many showed that both faculty and residents perceived deficiencies: e.g. language barrier, working with difficult patients, death & dying and giving bad news. Respondent demographics and comparisons among the three PGY levels will be discussed. Conclusion: Resident self-perceptions of deficiency in many areas of CS show significant discrepancies when compared to those of faculty. Identifying these areas is the first step in CS curriculum enhancement.
Background: ACGME Duty Hours Standards have been in place since July, 2003. The effects on knowledge acquisition during pediatric residency training are unknown, as no pediatric studies to date have looked at concrete differences in education and performance before and after duty hour implementation. In the present study, we sought to compare resident education pre- and post-duty hours using change in examination scores over the course of residency as an indicator. Methods: We compared the standardized test scores (in-training examination and certifying examination) of cohorts of Emory pediatric residents trained before (PGY-1 years 1997-2000) and after (PGY-1 years 2003-2006) the institution of work hour restrictions. We documented the change in exam score, from PGY-1 to PGY-3 year, and from PGY-1 year to certifying exam, between the two cohorts and then compared the change using a t-test of means. Residents without both a PGY-1 and PGY-3 in-training examination score were excluded from analysis. Certifying exam scores were not yet available for the 2005 and 2006 PGY-1 classes and thus not included. Results: There was no significant difference between the mean change in examination scores pre- and post-duty hours (PGY-1 to PGY-3 pre-: 200 vs. post-: 210, p ¼ 0.51; PGY-1 to certifying exam pre-: 284 vs. post-: 318, p ¼ 0.08). There was a significant difference between the mean scores of the before and after duty hour cohorts in every residency year (PGY-1 year pre:239 vs. post:175, p < 0.01; PGY-2 year pre:382 vs. post:325, p < 0.01; PGY-3 year pre:439 vs. post:384, p < 0.01). Certifying examination score means, however, were similar (pre:521 vs. post:526, p ¼ 0.82). Conclusions: While less exposure to the hospital, because of duty hour restrictions, might produce untoward Results in pediatric resident education, no such relationship was shown. Alternatively, there seems to be no enhancement of education after the institution of duty hour standards. Ongoing studies, incorporating multiple programs’ experiences and using a variety of surrogate markers, such as patient outcome data and resident/ faculty opinion, are needed to confirm our results.
18. GENDER DIFFERENCES IN RESEARCH GRANT APPLICATIONS FOR PEDIATRIC RESIDENTS Mary Beth Gordon, MD, Boston Combined Residency Program, Boston, MA Objective: Recent studies demonstrate gender differences in research grant applications and funding outcomes for medical school faculty. Our goal was to determine whether similar patterns exist for residents. Methods: We reviewed applications to a mentored research grant fund at a large academic pediatric residency program from 2003-2008. We characterized grant applicants (n ¼ 65) compared to eligible residents (n ¼ 327) with respect to applicant gender, evidence of prior research experience, and fellowship plans. We analyzed gender differences in type of project, mentorship, size of request, application score, whether funded, size of award, and % of request funded. We compared funded and unfunded applicants to determine significant predictors of success, and explored the relationship between gender and these predictors. Results: From 2003-2008, the fund supported 42 of 64 applications (66%). Men and women applied for grants in proportion to the gender composition of the residency (19% vs. 21%; p ¼ 0.77). Male and female applicants differed significantly in their median request ($5000 vs. $3350, p ¼ 0.03), application score (2.05 vs 2.66, p ¼ 0.003), and award ($5000 vs. $3000, p ¼ 0.02). The percent of request funded was the same. Men were more likely than women to hold an advanced research degree, and to apply for funding earlier in training. Funding success rates were not statistically different (77% men vs. 59% women, p ¼ 0.19). In logistic regression analysis, having an advanced research degree predicted successful funding (OR 15.8, p ¼ 0.01), and mitigated most gender effects. Conclusion: Gender differences in resident research grant proposals and funding mirror faculty patterns. In our study, these differences are explained largely by the correlation of gender with advanced research training. The degree may represent increased exposure to research, skill development (e.g. grant writing), strong mentorship, and appropriate cre-
20. THE IMPACT OF COMBINED PEDIATRIC RESIDENCY PROGRAMS ON THE EDUCATIONAL EXPERIENCE OF THE CATEGORICAL PEDIATRIC RESIDENTS Allen R. Friedland, MD, Med-Peds Program Director’s Association, Newark, DE, Tom A. Melgar, MD, Med-Peds Program Director’s Association, Kalamazoo, MI, David A. Kaelber, MD, PhD, Case Western Reserve University, Cleveland, OH, William L. Cull, PhD, American Academy of Pediatrics; Division of Health Sciences, Elk Grove, IL, John K. Chamberlain, MD, Univ of Rochester School of Medicine and Dentistry, Rochester, NY, Brian D. Kan, MD, SM, Cedars Sinai Medical Center, Los Angeles, CA Background: Current program requirements for pediatric residency programs and for med-peds programs have raised concerns about the possibility of a negative impact of combined residency training programs on pediatric programs. There are no published data on this subject. Methods: A random sample of 500 graduating third-year categorical pediatrics residents were surveyed as part of an annual pediatric survey in 2004. The responses were merged with the Accreditation Council for Graduate Medical Education (ACGME) database on residency program size and with the American Board of Pediatrics (ABP) categorical-pediatrics-only pass rates. Results: Responses were received from 303 graduating residents (62%). Among the 184 respondents who trained in programs with a combined training program the majority (60%) reported that the combined programs enhanced their educational experience. Another 39% thought the combined programs had no effect on their experience. Combined programs did not negatively affect self-reported outcomes variables or board pass rate. Graduates of small and medium categorical pediatrics programs were more likely than residents from large programs to report that the combined programs enhanced their experience (69% v. 50%, p ¼ .011). Conclusions: Our data do not support concerns that combined programs may negatively impact the educational experience of residents in the categorical pediatrics program but suggest a subjective enhancement of their experiences.
ABSTRACTS
ACADEMIC PEDIATRICS
view of teaching as an intellectual pursuit and awareness of ways to integrate teaching and research. FLC is an innovative and effective model of faculty development that promotes a sense of community among faculty.
dentialing. Programs to address gender disparities in grant funding should begin in undergraduate and graduate medical education, focusing on these individual skills and behaviors.
17. WE NEED TO TALK: DISCREPANCIES BETWEEN RESIDENT PERCEPTIONS OF THEIR COMMUNICATION SKILLS AND THOSE OF FACULTY Thanakorn Jirasevijinda, MD, Weill Cornell Medical College, New York, NY, Richard Neugebauer, PhD, Bronx-Lebanon Hospital Center, Bronx, NY
19. EFFECT OF DUTY HOURS STANDARDS ON PEDIATRIC RESIDENT EDUCATION Camden L. Hebson, MD, Kourtney K. Santucci, MD, Andrea L. Klopman, MD, Parminder Suchdev, MD, Lynn Gardner, MD, Susie Buchter, MD, Emory Pediatrics, Atlanta, GA
Introduction: Adults learn a subject best when they see its relevance and perceive a need for improvement. For communication skills (CS), little is known about resident self-perceptions on areas of weakness. Even less is known about how much these perceptions correlate with those of faculty. Objective: 1) Assess resident self-perceptions on deficits in CS, and compare them to those of faculty 2) Compare discrepancies among the three PGY levels. Methods: The Interactive Workshops On Communication and Cultural Sensitivity (IWOCCS) Program at the Bronx-Lebanon Hospital Center provides CS training to Pediatric Residents using interactive and peereducation models. As part of the program’s needs assessment, a survey was administered to 53 faculty and 53 residents, asking, ‘‘Which of the following areas pose a challenge for you/your residents in your/their interactions with patients?’’ The survey items were divided into 3 categories: 1) Rapport Building & Patient-Centered Care 2) Working with Specific Populations 3) Specific Topics in Communication; and their responses structured on the Likert Scale. Data analysis dichotomized responses into agree or other. Comparisons between faculty and resident responses on each item were analyzed using the chi-square test. Results: All three categories showed discrepancies between faculty and resident self-perceptions. The top five items were 1) Incorporating patients into decision making (p ¼ 0.02) 2) Talking about sexuality (p < 0.01) 3) Assessing family dynamics & need for social support (p < 0.01) 4) Understanding patient perspective (p ¼ 0.002) 5) Attention to non-verbal cues (p ¼ 0.03). For concordant items, many showed that both faculty and residents perceived deficiencies: e.g. language barrier, working with difficult patients, death & dying and giving bad news. Respondent demographics and comparisons among the three PGY levels will be discussed. Conclusion: Resident self-perceptions of deficiency in many areas of CS show significant discrepancies when compared to those of faculty. Identifying these areas is the first step in CS curriculum enhancement.
Background: ACGME Duty Hours Standards have been in place since July, 2003. The effects on knowledge acquisition during pediatric residency training are unknown, as no pediatric studies to date have looked at concrete differences in education and performance before and after duty hour implementation. In the present study, we sought to compare resident education pre- and post-duty hours using change in examination scores over the course of residency as an indicator. Methods: We compared the standardized test scores (in-training examination and certifying examination) of cohorts of Emory pediatric residents trained before (PGY-1 years 1997-2000) and after (PGY-1 years 2003-2006) the institution of work hour restrictions. We documented the change in exam score, from PGY-1 to PGY-3 year, and from PGY-1 year to certifying exam, between the two cohorts and then compared the change using a t-test of means. Residents without both a PGY-1 and PGY-3 in-training examination score were excluded from analysis. Certifying exam scores were not yet available for the 2005 and 2006 PGY-1 classes and thus not included. Results: There was no significant difference between the mean change in examination scores pre- and post-duty hours (PGY-1 to PGY-3 pre-: 200 vs. post-: 210, p ¼ 0.51; PGY-1 to certifying exam pre-: 284 vs. post-: 318, p ¼ 0.08). There was a significant difference between the mean scores of the before and after duty hour cohorts in every residency year (PGY-1 year pre:239 vs. post:175, p < 0.01; PGY-2 year pre:382 vs. post:325, p < 0.01; PGY-3 year pre:439 vs. post:384, p < 0.01). Certifying examination score means, however, were similar (pre:521 vs. post:526, p ¼ 0.82). Conclusions: While less exposure to the hospital, because of duty hour restrictions, might produce untoward Results in pediatric resident education, no such relationship was shown. Alternatively, there seems to be no enhancement of education after the institution of duty hour standards. Ongoing studies, incorporating multiple programs’ experiences and using a variety of surrogate markers, such as patient outcome data and resident/ faculty opinion, are needed to confirm our results.
18. GENDER DIFFERENCES IN RESEARCH GRANT APPLICATIONS FOR PEDIATRIC RESIDENTS Mary Beth Gordon, MD, Boston Combined Residency Program, Boston, MA Objective: Recent studies demonstrate gender differences in research grant applications and funding outcomes for medical school faculty. Our goal was to determine whether similar patterns exist for residents. Methods: We reviewed applications to a mentored research grant fund at a large academic pediatric residency program from 2003-2008. We characterized grant applicants (n ¼ 65) compared to eligible residents (n ¼ 327) with respect to applicant gender, evidence of prior research experience, and fellowship plans. We analyzed gender differences in type of project, mentorship, size of request, application score, whether funded, size of award, and % of request funded. We compared funded and unfunded applicants to determine significant predictors of success, and explored the relationship between gender and these predictors. Results: From 2003-2008, the fund supported 42 of 64 applications (66%). Men and women applied for grants in proportion to the gender composition of the residency (19% vs. 21%; p ¼ 0.77). Male and female applicants differed significantly in their median request ($5000 vs. $3350, p ¼ 0.03), application score (2.05 vs 2.66, p ¼ 0.003), and award ($5000 vs. $3000, p ¼ 0.02). The percent of request funded was the same. Men were more likely than women to hold an advanced research degree, and to apply for funding earlier in training. Funding success rates were not statistically different (77% men vs. 59% women, p ¼ 0.19). In logistic regression analysis, having an advanced research degree predicted successful funding (OR 15.8, p ¼ 0.01), and mitigated most gender effects. Conclusion: Gender differences in resident research grant proposals and funding mirror faculty patterns. In our study, these differences are explained largely by the correlation of gender with advanced research training. The degree may represent increased exposure to research, skill development (e.g. grant writing), strong mentorship, and appropriate cre-
20. THE IMPACT OF COMBINED PEDIATRIC RESIDENCY PROGRAMS ON THE EDUCATIONAL EXPERIENCE OF THE CATEGORICAL PEDIATRIC RESIDENTS Allen R. Friedland, MD, Med-Peds Program Director’s Association, Newark, DE, Tom A. Melgar, MD, Med-Peds Program Director’s Association, Kalamazoo, MI, David A. Kaelber, MD, PhD, Case Western Reserve University, Cleveland, OH, William L. Cull, PhD, American Academy of Pediatrics; Division of Health Sciences, Elk Grove, IL, John K. Chamberlain, MD, Univ of Rochester School of Medicine and Dentistry, Rochester, NY, Brian D. Kan, MD, SM, Cedars Sinai Medical Center, Los Angeles, CA Background: Current program requirements for pediatric residency programs and for med-peds programs have raised concerns about the possibility of a negative impact of combined residency training programs on pediatric programs. There are no published data on this subject. Methods: A random sample of 500 graduating third-year categorical pediatrics residents were surveyed as part of an annual pediatric survey in 2004. The responses were merged with the Accreditation Council for Graduate Medical Education (ACGME) database on residency program size and with the American Board of Pediatrics (ABP) categorical-pediatrics-only pass rates. Results: Responses were received from 303 graduating residents (62%). Among the 184 respondents who trained in programs with a combined training program the majority (60%) reported that the combined programs enhanced their educational experience. Another 39% thought the combined programs had no effect on their experience. Combined programs did not negatively affect self-reported outcomes variables or board pass rate. Graduates of small and medium categorical pediatrics programs were more likely than residents from large programs to report that the combined programs enhanced their experience (69% v. 50%, p ¼ .011). Conclusions: Our data do not support concerns that combined programs may negatively impact the educational experience of residents in the categorical pediatrics program but suggest a subjective enhancement of their experiences.